Healthcare Provider Details

I. General information

NPI: 1588640734
Provider Name (Legal Business Name): TERESA JANE SPRAGGINS LCSW LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TERESA JANE POST

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 12/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 LINDEN ST
WESTOVER WV
26501-4067
US

IV. Provider business mailing address

40 LINDEN ST
WESTOVER WV
26501-4067
US

V. Phone/Fax

Practice location:
  • Phone: 304-291-3858
  • Fax: 304-291-3858
Mailing address:
  • Phone: 304-291-3858
  • Fax: 304-291-3858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1535
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCP00816357
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: